Provider Demographics
NPI:1912995549
Name:RUIZ, JUDITH E (LCSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 5TH AVE RM 1402
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5034
Mailing Address - Country:US
Mailing Address - Phone:212-505-0419
Mailing Address - Fax:877-471-4540
Practice Address - Street 1:347 5TH AVE RM 1402
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5034
Practice Address - Country:US
Practice Address - Phone:212-505-0419
Practice Address - Fax:877-471-4540
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02702611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01622917Medicaid
NYN60651OtherEMPIRE BCBS
NY0023737OtherGHI
NYR027026OtherHIP
NY052616OtherAETNA HMO
NY084627OtherEBCBS
NY0846270OtherAETNA
NY857113OtherFIRST HEALTH
NY109546OtherVALUE OPTIONS
NY308765AOtherMAGNA CARE
NY5154728OtherMAGELLAN HEALTH SERVICES
NY0348145OtherCIGNA
NY07205OtherCIGNA HMO
NY108537OtherMANAGE HEALTH NETWORK
NY69340OtherUNITED BEHAVIORAL HEALTH
NY69340OtherUNITED BEHAVIORAL HEALTH